The NCHS is a division of the Department of Health and Human Services in conjunction with the Centers for Disease Control and Prevention (CDC). It’s report found that 63,600 deaths occurred in 2016, the most lethal year yet of the drug overdose epidemic. That is more deaths than the 41,000 lost each year to breast cancer.

The rate of overdose deaths from all types of drugs increased by 10% each year from 1999 to 2006, then leveled off from 2006 to 2014. However, the rate increased by 18% from 2014 to 2016.

However, the study found that opioid overdose deaths are outpacing deaths from other types of drugs. The rate of opioid overdose deaths increased by 18% per year from 1999 to 2006. The rate then increased by 88% from 2013 to 2016.

Overdose deaths involving opioids, like fentanyl and tramadol, doubled between 2015 and 2016, primarily driven by fentanyl, according to a CDC report published in October.

The states hit the hardest by the opioid epidemic were West Virginia, Ohio, New Hampshire, District of Columbia and Pennsylvania. Those states had the highest drug overdose death rates in 2016. Ohio was hit especially hard by the epidemic.

The researchers warn that the opioid epidemic is widespread enough that it is affecting the life expectancy of Americans overall. The U.S. life expectancy decreased 0.1%; the second year in a row it has decreased. The researchers blame that decrease on the opioid epidemic.